Is Cord Blood Banking Worth It? The Great Debate
As a parent, you want to do everything possible to keep your children healthy. For some, that desire spurs them to sign up for umbilical cord blood banking as an insurance policy to help their kids in case they’re faced with a serious health issue down the road.
With cord blood banking, stem cells are removed from an infant’s umbilical cord once it’s been clamped and cut. The sample is then sent to a lab and frozen. The idea is that one day, if needed, these stem cells can be thawed and used to treat certain health conditions and diseases.
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There is also a process called “delayed cord clamping,” which involves doctors waiting at least 30 to 60 seconds after birth to clamp the cord. According to the American College of Obstetricians and Gynecologists (ACOG), several studies have suggested that waiting a minute or so will increase blood volume, lesson the need for a blood transfusion, and result in lower frequency of iron deficiency anemia in term babies. However, notes the organization, there is no “ideal” time to wait before clamping the cord.
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ACOG did acknowledge the potential benefits of cord blood clamping in preterm babies, stating “The single most important clinical benefit for preterm infants is the possibility for a nearly 50% reduction in intraventricular hemorrhage.”
If parents do opt for delayed clamping, it shouldn’t interfere with cord blood banking. According to a press release by Americord Registry: “There is little impact on the ability to collect cord blood when parents choose to delay the clamping of the umbilical cord. While a growing number of expecting parents have been learning more about the option to delay clamping of their baby’s umbilical cord, many have also been misinformed that they must choose between delayed clamping and cord blood banking. Both actions provide important value to parents and baby and are not incompatible with one another.“
Americord CEO Martin Smithmyer said in the release, “It is exciting to see the growing evidence that expecting parents can both delay clamping and bank their baby’s cord blood. We are happy to say that, with Americord, we have seen little negative impact on cord blood banking from delayed cord clamping.”
But there’s a legitimate debate over potential versus promise — namely, what these stems cells may be able to do in the future as technology advances, versus what they can actually do for your family now.
Is it really worth it to opt for cord blood banking? (Photo: Getty Images)
The Research
Stems cells are a potentially powerful therapy. Umbilical cord blood stem cells are used to treat four primary illnesses, according to a 2011 study published in the Journal of Perinatal Education: Cancers such as lymphoma and leukemia, blood disorders such as sickle-cell anemia and Fanconi’s anemia, congenital metabolic disorders, and immunodeficiencies.
However, certain medical professionals and researchers question its current usefulness. According to a 2011 study published in the Journal of Assisted Reproductive Medicine: "…if the cord blood from an infant donor has an inherited hematologic, immunologic, or genetic disorder, then cord blood may not be used to expect a cure for the same disease in the same recipient. Therefore, families with recognized genetic diseases should be made aware of these issues.”
In other words, if a child has leukemia, he won’t be able to use his own umbilical cord blood stem cells as a treatment option since the genetic mutations that lead to the cancer exist in the DNA of his cord blood. As the researchers put it: “Using one’s own stem cells would be, in effect, ‘contaminating’ oneself with the same disease process.”
So it’s no surprise that the chances of a baby using stems cells from his own cord blood as part of a treatment strategy are very slim: A University of California at San Francisco (UCSF) study found that there’s a 0.04 percent chance of a baby requiring a transplant of his own stored stem cells to treat a disease and a 0.07 percent chance that the baby’s sibling will require a stem cell transplant from the baby’s stored cord blood.
Cord blood banking also comes with a hefty price tag for something you’re not likely to use: an estimated cost of $3,620 minimum for banking and storage for 20 years, which UCSF researchers say is not cost-effective. However, the researchers note that private umbilical cord blood banking is cost-effective for children with a very high likelihood of needing a stem cell transplant, such as a sibling with a preexisting health condition.
What the Experts Say
The American Academy of Pediatrics flat-out discourages private cord blood banking. “Because there are no scientific data at the present time to support autologous [the baby’s own] cord blood banking and given the difficulty of making an accurate estimate of the need for autologous transplantation [donating stems cells to yourself] and the ready availability of allogeneic transplantation [receiving stem cells from another donor], private storage of cord blood as 'biological insurance’ should be discouraged,” according to the AAP.
Most experts agree, saying that it’s unlikely your baby will ever be able to use the stem cells from his own cord blood. “I don’t tell any of my patients not to do it, but I point out that the odds that they will ever use the stored cord blood are very low,” Stephen Feig, professor of pediatrics at UCLA, tells WebMD. “It’s a very expensive insurance policy. The diseases in children that we can treat with their own cord blood stem cells are really rare.”
Arthur Caplan, PhD, a bioethicist and chairman of the department of medical ethics at the University of Pennsylvania, agrees: “If a child develops certain genetic diseases, his or her own frozen cord blood isn’t going to help,” he tells WebMD. “The cord blood will have the same genetic flaws that caused the disease in the first place, so it won’t be a good treatment.”
That said there are scenarios in which banking cord blood can be beneficial, such as a cord blood stem cell donation from a newborn to an older sibling with a blood disease, who might benefit from stem cell treatment, according to Memorial Sloan Kettering Cancer Center.
Stem cells from cord blood can also help non-relatives (aka strangers), which is why several organizations, such as the AAP, encourage public cord blood banking over private banking where it can benefit more people.
In general, if you’re considering private cord blood banking, know its limitations. If you decide not to do it, don’t feel bad about it. “I think it’s fine if a parent makes an informed decision to do this,” says Caplan. “But I don’t like parents being guilted or shamed into this by misleading advertising. No one should make you feel like irresponsible or reckless parents if you don’t choose to bank your child’s cord blood.”
What Parents Say
“We banked all three of our kids’ cord blood. We did it in case it can be used to do something helpful or life-saving for them in the future, as science advances.” —Mu-En S.
“We didn’t do cord blood banking with either of our kids. Basically, all of the pediatricians I spoke to said it was a waste of money. So for us it was a question of cost and the general sentiment that it would likely never be useful. I think [the cord blood banking] industry preys on the fear of first-time and anxiety-prone parents.” —Lisa S.
“Cord blood banking wasn’t offered to us when we had our first child, but we did it for our second and third kids. To us, it was worth the thousands of dollars that it cost if it could ever help our children.” — Tony Baraz.
The Bottom Line
If cord blood banking is something your family can afford, there’s no harm in doing it, and it may even be beneficial if, for example, a biological sibling has a health condition that can be treated with a cord blood stem cell transplant. If you’re not planning on doing cord blood banking because it’s too expensive or because of its limitations, consider donating your baby’s umbilical cord blood to a public cord blood bank, where it can benefit others in need of stem cell transplants.
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